Comparing DMDD and ODD

Temper tantrums are typical kid behavior. Children often resort to them to express what they need or want when they don’t have the words to do so, don’t have the tools to self-regulate, or lack a basic need. But, as kids mature, they usually replace temper tantrums with more socially appropriate ways to communicate. 

So what happens when this behavior doesn’t stop or even gets worse? This could be an indication that your child is living with disruptive mood dysregulation disorder (DMDD) or oppositional defiant disorder (ODD). Distinguishing between these conditions can be tricky because their symptoms can look similar. 

With both of these mental health conditions, children frequently feel angry or irritable — and these feelings go beyond the typical emotions experienced by kids. Parenting a child with DMDD or ODD can be very stressful and upset the family dynamic. Know that support is available to help you and your child manage their condition. 

What are the differences between DMDD and ODD?

Unless you’re a child psychologist, it can be hard to spot the difference between DMDD and ODD. If you suspect that your child might have one of these mental health conditions, a professional evaluation is necessary to receive a formal diagnosis and treatment. 

Defining characteristics of DMDD

Kids with DMDD throw severe and frequent tantrums, have verbal rages, and can be physically aggressive toward people and property. They often also struggle to regulate their emotions. In between this explosive behavior, children are usually irritable and angry. 

While both conditions can be challenging, DMDD is considered more severe than ODD. That’s because, despite many overlapping symptoms, kids living with DMDD have a significant mood component.

Defining characteristics of ODD

ODD can look similar. Children with ODD lose their temper often, are easily annoyed, angry, and resentful. They also can defy authority figures, like parents and teachers. Their behavior can also include seeking revenge against someone. 

Spotting DMDD vs ODD

For example, a child with DMDD might react very angrily if they’re told they can’t have more ice cream while eating at a restaurant. They might yell at their parents, kick or hit them, and throw their bowl across the restaurant. This sort of behavior would repeat throughout the week. 

In a similar scenario, a kid with ODD would severely lose their cool too. They might argue over getting more ice cream, refuse to follow their parents’ instructions, and be irritated and rude the rest of the evening. They may even sneak a treat when they get home and lie if they get caught.

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Can a child have ODD and DMDD together?

ODD and DMDD are separate diagnoses, and you can’t have both at the same time. 

DMDD is a relatively new diagnosis, as it was introduced into the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 2013. It was created to reduce the number of kids diagnosed with pediatric bipolar disorder (PBD). Children were being diagnosed with PBD even though their symptoms looked different than the broader version of bipolar disorder. The introduction of DMDD more accurately captured the symptoms children were displaying.  

Many parents may notice that their child meets the criteria for both ODD and DMDD and wonder which diagnosis their child needs. To be clear, children with DMDD can’t also be given a diagnosis of ODD. If a child meets the criteria for both conditions, a healthcare provider should diagnose them with DMDD. This is because DMDD is considered to be a more severe condition with a more significant mood component.

What kinds of conditions co-occur with ODD and DMDD?

Even though a child can’t be diagnosed with ODD and DMDD together, they can have other diagnoses that can co-occur (happen at the same time). You may notice that your child’s symptoms also overlap with a few other diagnoses.

DMDD frequently co-occurs with attention-deficit hyperactivity disorder (ADHD) and conduct disorder. Children with DMDD and ADHD struggle with impulsivity and emotional regulation. They may also have difficulty staying focused, which can lead to challenges in school and social settings. Additionally when DMDD is present alongside conduct disorder, there may be an increased risk of aggression, defiance, and persistent behavioral issues. 

Anxiety disorders and ADHD also commonly co-occur with ODD. Children with ODD and anxiety disorders often worry excessively, have difficulty managing stress, and experience heightened emotional reactivity. Children with ODD and ADHD may experience impulsivity, inattention, and difficulty following rules and routines. The combination of ODD with anxiety or ADHD can make it challenging for children to regulate their emotions and behaviors. 

Supporting children with DMDD or ODD 

If your child receives a diagnosis of DMDD or ODD, you might feel a mix of emotions. On the one hand, you might feel relieved that you finally have an explanation for your child’s behavior. But you could also feel surprised or even shocked.

Here’s what to do after your child receives a diagnosis:

• First, take time to process the diagnosis. Remember that an accurate diagnosis is an important first step toward supporting your child and improving the emotional health of your family. 
• Next, speak to your child about the results from their testing. Being open and honest can help. You can say, “Remember that big test you took with Dr. Smith? They told us that they know why you sometimes have big feelings and trouble with your actions. Now that we know what’s going on, we can work hard as a team to help with those feelings!”
• Then, reach out to treatment resources to get the best possible support. You can also schedule a meeting with the support staff at your child school to get an IEP if there isn’t something like that already in place.

Treatment options for DMDD

For children with DMDD, cognitive behavioral therapy (CBT) is a first-choice treatment. It’s designed to help people recognize and change their unhelpful and negative thoughts, while also providing coping strategies for intense emotions. 

It can also be beneficial to try family therapy. Family therapy can help identify family dynamics that negatively affect a child’s DMDD symptoms. A therapist can also help you determine how DMDD symptoms impact each member of the family.

Parent training is another strategy you can try. It teaches parents how to effectively respond to behavior patterns from DMDD, like severe temper tantrums. It can also help parents learn how to reward their child’s positive behaviors. 

In some cases, medication can also help with DMDD. If you think your child might benefit from medication, discuss this with a healthcare provider.

Treatment options for ODD

Parent training and family therapy can also be helpful if your child is diagnosed with ODD. Additionally, parent-child interaction therapy (PCIT) can be an additional step. With PCIT, a therapist coaches you via an ear-bug device as you and your child interact. 

Social skills training can be another strategy. Your child will learn how to better interact with others, like classmates, teachers, and caregivers.

Find care with Rula

As a parent, you probably anticipated that you’d have to deal with temper tantrums from time to time. After all, they’re usually unavoidable with children. But mental health conditions like DMDD or ODD might not have been on your radar. 

With Rula, you’re not alone in supporting a child with one of these conditions. Rula’s therapist matching tool can help you find an in-network therapist who can help you and your child learn how to manage their DMDD or ODD. With Rula’s extensive network of over 10,000 providers, you can find one who’s compatible with your family’s needs and meet as soon as tomorrow via live video call.

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